Document Detail

Determination of hydration status in hemodialysis patients with whole body and calf bioimpedance techniques.
MedLine Citation:
PMID:  21951636     Owner:  NLM     Status:  Publisher    
BACKGROUND:  Bioimpedance methods have been used for decades to estimate whole body extracellular (wECV), intracellular (wICV) and total body water (TBW) volumes. The aim of this study was to demonstrate the ability of widely used bioimpedance techniques to assess dry weight (DW) and to predict a state of normal hydration (NH) in hemodialysis patients whose post dialysis weight had been gradually reduced from baseline in successive treatments over time. METHODS:  Calf bioimpedance spectroscopy (cBIS) was employed to determine DW (DW(cBIS) ) as defined by flattening of an intradialytic continuously measured resistance curve and by normalized resistivity (nRho) being in the gender-specific normal range. The wECV/TBW ratio was determined by "classical" wrist-to-ankle whole body bioimpedance (wBIS); in addition, a novel whole body model (WBM) based on wBIS was used to predict normal hydration weight (NHW(WBM) ). RESULTS:  Twenty one HD patients were studied; 11 ± 6 bioimpedance measurements were performed per patient. Nine patients (43%) reached DW(cBIS) (DW(cBIS) group), while 12 patients (53%) remained fluid overloaded over the course of the study (non-DW(cBIS) group). Change in wECV as measured by wBIS accounted for 46 ± 23% in DW(cBIS) group which was higher than in non-DW(cBIS) group (33 ± 48%, p < 0.05) of actual weight loss at the end of study. In both groups the wECV/TBW ratio did not change significantly between baseline and study end. Mean predicted NHW(WBM) at baseline was 3.55 ± 1.6 kg higher than DW(cBIS) . The difference in DW(cBIS) and NHW(WBM) was 1.97 ± 1.0 kg at study end. CONCLUSION:  WBM could be useful to predict a target range of normal hydration weight particularly for patients with substantial fluid overload. The cBIS provides an accurate reference for the estimation of DW so that the combined use of cBIS and WBM is promising and warrants further studies.
Li Liu; Fansan Zhu; Jochen Raimann; Murat H Sipahioglu; Gregory Wystrychowski; Thomas Kitzler; Stephan Thijssen; Ciro Tetta; Peter Wabel; Peter Kotanko; Nathan W Levin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-27
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1797     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.
Renal Research Institute, New York Division of Nephrology and Hypertension, Beth Israel Medical Center New York, NY Institute of Nephrology, Peking University First Hospital Beijing, China Fresenius Medical Care, Bad Homburg, Germany.
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